Dr. Mitchell investigated the reasons couples make an agreement, the structure of the arrangement (such as when it was established and what behavior is and is not allowed), and whether the agreement is ever broken during the relationship. Dr. Mitchell’s findings are published in the Journal of Sex Research.

Dr. Mitchell recruited the participates using paid Facebook advertisements targeted to appear on pages of men who identified as being 18 and older, living in the U.S., interested in men, and having a current relationship status as either being in a relationship, engaged, or married.

Men who have sex with men (MSM) account for about 2% of the population yet represent more than half of all new and existing HIV infections, according to the Centers for Disease Control and Prevention (2010). HIV and sexually transmitted infection (STI) prevention was given as the primary reason for couples to create the agreement. However, Dr. Mitchell found significant discrepancies in areas such as when the partners believed the agreement was in place and adherence to the agreement. He explains that 31% of study participants said they or their partner had broken their agreement.

In addition, Dr. Mitchell discovered that a higher percentage (27%) of couples with one HIV-positive partner were more likely to break the agreement, compared to (18%) when partners had the same status.

The majority of MSM reported having unprotected sex approximately 80 days into the relationship, but the agreements, on average, were not established until several months later.

Dr. Mitchell says these findings showcase the need for gay male couples to have more honest and explicit discussions when establishing and honoring sexual agreements. Furthermore, the research highlights the need for strengthening HIV prevention among gay couples.

"The majority of HIV prevention efforts have targeted gay, bisexual, transgender, and other MSM as individuals, in groups, or at the community-level,” says Dr. Mitchell. “Yet estimates in the U.S. indicate that one-third to two-thirds of men acquire HIV while in their same-sex relationship. My research considers how sexual agreements and other characteristics of gay male couples' relationships affect their sexual health and risk for acquiring HIV and sexually transmitted infections (STIs). To help improve prevention efforts and provide couples' with appropriate sexual health resources, it's important to understand what's happening in their relationships."